Hospitalization

Confinement or In-patient
Out-patient Care
Prevention Health Care
Emergency Care
Dental Health Care
 BENEFIT REMARKS
No deposit upon admission Covered
According to type of plan
Room and Board
enrollment
Use of operating theatre and
Covered with DDL
Recovery Room
X-ray and laboratory examinations Covered with DDL
Services and MediCard Specialist Covered with DDL
Surgery and anesthesia Covered with DDL
Administered medicines Covered with DDL
Dressings, sutures and plaster casts,
Covered with DDL
etc.
Fresh whole blood (including
screening/processing) and intravenous Covered with DDL
fluids
 BENEFIT REMARKS
Human Blood Products (including
screening/processing) except Covered with DDL
gamma globulin
ICU confinements Covered with DDL
Chemotherapy 10 sessions within DDL
Radiotherapy
-Intensified Modulated Therapy
- 3DCRT 10 sessions within DDL
-Tomotherapy
-Brachytherapy
Dialysis
- Continuous Renal Replacement 10 sessions within DDL
Therapy (CRRT)
Admission Kit including wee bag Covered
All other items directly related
Covered with DDL
to the management of the case
Visitation of MediCard liason
Covered
officer
Modern Therapeutic Procedure
Complex Diagnostic Procedure
New Diagnostic & Therapeutic
Modalities
 OUTPATIENT CARE SERVICES
BENEFIT REMARKS
Covered with DDL; except
Regular Consultations & Treatment
prescribed medicines
Covered with DDL; except
Referral to specialists
prescribed medicines
Treatment of Minor injuries and
Covered within DDL
surgery not requiring confinement
X-ray and laboratory examinations Covered within DDL
EENT Treatment Covered within DDL
PT / Speech Therapy Up to 10 sessions within DDL
Laser Treatment of Glaucoma and
Up to P 20,000.00
Retinal Detachment
Cataract Extraction (Excluding cost
of lens), including Covered within DDL
phacoemulsification
Pre & Post natal consults Except labs
Sclerotherapy (except for cosmetic
Up to P 5,000.00
purposes & cost of sclerosing agent)
 BENEFIT REMARKS
Cauterization of warts (including
Up to P 1,000.00
facial warts)
Allergy Testing Up to P 2,500.00
First dose of Anti-Rabies,
Up to P 5,000.00
anti-venom, anti-tetanus
Tuberculin Test (except screening) Up to P 1,000.00
Consultations for Chronic
Covered
dermatoses (except psoriasis)
Consultations for scabies Covered
 BENEFIT REMARKS
Annual Physical Examination (APE)
Covered
to include
Complete Blood Count Under APE
Urinalysis Under APE
Fecalysis (stool exam) Under APE
Chest X-Ray Under APE
Under APE; For adults age 35 and
Electrocardigram
above, or if prescribed
Under APE; For women age 35 and
Pap Smear
above, or if prescribed
Management of Health Problems Covered
Routine Immunization Except administered vaccine
Counseling on Health habits, diets
Covered
and Family Planning
Record keeping of medical history Covered
In accredited Hospitals
In Non-accredited Hospitals
In Foreign Countries
Ambulance Services and
Emergency Medical
Assistance
 BENEFIT REMARKS
Oral Prophylaxis Once a year
Consultations and oral
Covered
examinations
Limited to simple tooth extraction;
Tooth Extractions excluding surgery for impacted or
ankylosed tooth, etc.
Temporary Fillings Covered
Gum treatments for cases like
Covered
inflammation or bleeding
Recementation of loose jackets,
Covered
crown, in-lays and on-lays
Treatment of mouth lesions,
Covered
wounds and burns
Adjustment of Dentures Covered
Emergency out-patient dental
In accredited dental clinics only
treatment
 BENEFIT REMARKS
Temporomandibular Joint (TMJ)
Covered
Consultations
Restorative and Prosthodontic
Covered
consultation
Dental Nutrition & Dietary
Counseling through chairside Covered
instruction
Dental Health Education Covered
Prenatal and Postnatal
Covered
consultations
 Work-related illness/accidents,
Unprovoked Assault, Congenital Illness,
Slipped Disc, Scoliosis, Spondylosis,
Spinal Stenosis
 PET Scan, Stapled Hemorrhoidectomy
 Cryosurgery, Hyperventilation Syndrome
 Pre-Employment services
 Free consultations at MediCard owned
clinics
24/7 Call Center
Service/Access
Text MediCard
Vaccines
 Any illness, injury or any adverse medical
condition shall be considered pre-existing if
during the entire period prior and within the
first 12 months from the effective date of
this agreement.
For at least 30 Principal Members and succeeding Members
Years of Membership Amount of Coverage
Up to P 5,000.00 per illness per
1st year
member per year
Up to P 5,000.00 per illness per
member per year provided that
the pathogenesis or onset of such
2nd year illness, injury or adverse medical
condition started prior to or
during the contestability period,
up to DDL.
Potentially or actually life-
threatening conditions or illness
which may require prolonged or
repeated hospitalizations or
intensive care management.
 PRINCIPAL MEMBER
- at least 18 years old up to age 60 and employed by the
company.

 QUALIFIED DEPENDENT MEMBER

For Single Principal For Married Principal For Single Parent
Members Members Principal Members

Legal Spouse up to Children, 30 days old

Parents up to Age 60
age 60 up to 21 years of age

Siblings, 30 days old Children, 30 days old

up to 21 years of age up to 21 years of age
OPTION 1:
With AHMC, MMC, SLMC-QC, TMC & CSMC; without SLMC-Global City

SEMI-ANNUAL ANNUAL MAXIMUM

ROOM AND
PREMIUM PREMIUM (PER DREADED DISEASE
BOARD
(PER HEAD) HEAD) LIMIT

Semi-Private
(Open) Without P 4,962.00 P 9,362.00 P 80,000.00
AHMC

Small Private
P 6,639.00 P 12,526.00 P 100,000.00
(Open)
Large Private
P 7, 875.00 P 14,858.00 P 150,000.00
(Open)
OPTION 2:
Without AHMC, MMC, SLMC-QC, SLMC-Global City, TMC & CSMC

ROOM AND SEMI-ANNUAL MAXIMUM

ANNUAL PREMIUM
BOARD PREMIUM (PER HEAD) DREADED LIMIT
(PER HEAD)

Semi-Private
P 3,695.00 P 6,972.00 P 75,000.00
(Open)

Small-Private
P 5,130.00 P 9,679.00 P 90,000.00
(Open)

Large Private
P 6,375.00 P 12,029.00 P 120,000.00
(Open)